Most previous guidance on the management of chronic constipation has focussed on the use of medication. However, new guidance funded by the British Dietetic Association, and produced by a team of UK-based clinicians (Dimidi et al, 2025), gives the first comprehensive evidence-based dietary guidelines for the management of chronic constipation in adults. As well as the effect on the bowel, chronic constipation prospectively associated with an increased risk of urgency and hesitancy among parous middle-aged women (Alhababi et al, 2021).
Chronic constipation is characterised by infrequent stools, difficult stool passage, or both, and affects 10.1% of the global population (Barbiero et al, 2021). It significantly impacts quality of life. Nearly all patients try lifestyle management options for symptom relief, including dietary modifications that often focus on increasing dietary fibre intake. However, more than half are not satisfied with their current treatment (Johanson and Kralstein, 2007), highlighting an urgent need to improve management strategies for chronic constipation.
The authors summarised the main points of the guidance as:
- These are the first guidelines specifically for the dietary management of chronic constipation and are based on evidence from robust systematic reviews following the GRADE process.
- Psyllium supplements, certain probiotic strains, magnesium oxide supplements, kiwifruits, rye bread and high mineral water are recommended to improve specific constipation outcomes.
- No recommendations were made on whole diet approaches (e.g. high fibre diet) because of a lack of evidence.
Recommendations were made for dietary supplements, foods and drinks that have never been previously included in clinical guidelines, and can now be rapidly implemented into clinical practice, thereby improving clinical care and patient outcomes.
Contact us
